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10/Aug/2022

Although it sounds like it, a Baker’s cyst isn’t named after an occupation like housemaid’s knee (prepatellar bursitis), policeman’s heel (plantar calcaneal bursitis) or writer’s cramp (hand dystonia). It has nothing to do with the act of making delicious, delicious bread 🍞 or other baked goods 😋.

Baker’s cysts are named after Dr W.M Baker, the 19th-century surgeon who first described cysts that form on the back of the knee. Their clinical name is popliteal cyst. Often people don’t know they have a Baker’s cyst, especially if it’s not causing pain. However, sometimes they can cause problems.

Your knee – a complex joint

To understand how a Baker’s cyst affects your knee, it’s helpful to know a little about your knee joint.

Your knee is a large and complex joint where three bones meet: your thighbone (femur), shinbone (tibia) and kneecap (patella). Covering the ends of your bones is a thin layer of tissue called cartilage. It provides a slippery cushion that absorbs shocks, helps your joints move smoothly and prevents bones from rubbing against each other.

Surrounding the joint is a tough capsule filled with a lubricating fluid (synovial fluid). This fluid allows your knee to move freely.

A Baker’s cyst can form when an injury or arthritis causes your knee to produce too much synovial fluid. This excess fluid bulges from the joint capsule behind the knee as a protruding sac (see image).

Cysts can vary in size and cause symptoms such as pain or stiffness in the knee joint.

Baker’s cysts may not require treatment, but if they do, they can be treated effectively with self-care and medical treatment.

Causes

Some of the common causes of Baker’s cyst include:

Symptoms

Often, there are no symptoms, and you may not even know you have a cyst. If symptoms do occur, they can include:

  • a lump or swelling behind the knee
  • knee pain
  • stiffness or tightness of the knee
  • limited range of knee movement (if the cyst is large).

Diagnosis

Many people don’t know they have a Baker’s cyst as it may be small and painless.

However, you should see your doctor if you notice a painful lump in the space behind your knee.

Your doctor will ask about your symptoms and medical history and examine your knee. They’re usually able to diagnose a Baker’s cyst based on this.

Sometimes a doctor may organise scans of the joint, usually an ultrasound, or if the diagnosis is uncertain, possibly an MRI (magnetic resonance imaging). This is to rule out other rare causes of the lump, such as a popliteal aneurysm, blood clot or tumour.

Complications

The symptoms of a Baker’s cyst are usually mild; however, in rare cases, the cyst may burst, leaking fluid into the calf region. This can cause increased pain in the knee and swelling or redness in the calf.

If you experience swelling or warmth in your calf, you should seek medical advice quickly.

It can be difficult to tell the difference between the complications of Baker’s cyst and more serious but less common problems such as a blood clot in a vein in your leg. So it’s better to be safe and get it checked out.

Treatment

You probably won’t need treatment if you have no symptoms or only mild pain.

However, if it is causing you pain, your doctor will develop a treatment plan that may include:

  • Self-care. You can reduce the pain and swelling by using an ice pack on your knee for short periods. Make sure to wrap it in a cloth so the pack doesn’t come into direct contact with your skin. You should also protect and rest the joint. Elevate your knee while resting it, and avoid activities that strain your knee (e.g. jogging). You may also find it helpful to use a cane or crutches for a short period or wear a knee support.
  • Medicines such as paracetamol or non-steroidal anti-inflammatory medicines (e.g. ibuprofen) may provide temporary pain relief. These medicines are available over-the-counter or with a prescription, depending on their dosage and other ingredients.
    A corticosteroid (steroid) injection may be helpful for people who haven’t found relief from other treatments or if they have severe pain.
  • Treating the underlying condition (e.g. arthritis) is also important, so your doctor may discuss other medicines and treatment options.
  • Seeing a physiotherapist or exercise physiologist for gentle strengthening and range of movement exercises to reduce symptoms and maintain knee function.
  • Draining the cyst by inserting a needle into it (needle aspiration) and removing the fluid. This may be done under ultrasound.
  • Surgery is rarely needed to treat a Baker’s cyst. However, it may be an option in some cases to treat the cause of the cyst (e.g. an injury) or to remove the cyst if all other treatments haven’t provided relief.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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10/Aug/2022

Written by hand therapist Catherine Reid, B.App. Sci, (OT), M.Sci (H&UL rehab), MAHTA (As awarded by the AHTA), CHT(USA)

A surgeon once told me that the human body’s most elegant anatomy was in the hand. I might be slightly biased, but I had to agree! The hand is amazing and complex in the way it’s structured and works.

There are 27 bones in your hand compared with just 3 in your leg. These bones are moved by over 30 muscles, all working in unison to provide smooth, coordinated movements. Your nerves help you control these movements enabling you to adjust your strength or fine coordination to suit the task.

Your hands can convey your feelings through touch and gesture and help to communicate your thoughts. In fact, some people will tell you they can’t talk without using their hands!

Your wrists, elbows and shoulders work together to position your hands in space. Any problem along the chain of your upper limbs affects your ability to fully function. Imagine how difficult it would be to reach up to do your hair if your shoulder was stiff, or to do downward dog in yoga with a painful wrist!

We connect with the world through our hands, performing everyday activities, and many of us earn our living with our hands. That’s why it’s essential that we take good care of our hands.

For some people, this may include seeing a professional.

What is hand therapy?

Considering the importance of our hands, it should be no surprise that there are professionals devoted solely to their rehabilitation.

Hand surgeons are either orthopaedic or plastic surgeons who’ve undergone additional training and study to specialise in treating problems of the hands, wrists and arms. They may use surgical and/or non-surgical treatments.

Hand therapy practitioners are qualified physiotherapists or occupational therapists registered with the Allied Health Practitioner Regulation Agency (AHPRA). They have extensive knowledge and skill in understanding and treating problems with the fingers, wrists, elbows and shoulders. The Australian Hand Therapy Association (AHTA) defines hand therapy as “the art and science of rehabilitation of the upper limb – shoulder to fingertip”.

What is an Accredited Hand Therapist (AHT)?

In 2017, the Australian Hand Therapy Association implemented a credentialing program to ensure accredited therapists offer a high standard of practice. All Accredited Hand Therapists have undertaken advanced education and assessment of the upper limb and have had over 3,600 hours of hand therapy clinical practice. After they’re assessed as competent to provide safe, evidence-based diagnosis, advice, and treatment, they’re awarded the credential of Accredited Hand Therapist by the Australian Hand Therapy Association Credentialing Council.

What conditions are treated?

Accredited Hand Therapists diagnose and treat a large variety of musculoskeletal conditions of the upper limb. They include:

  • arthritis
  • nerve compressions (e.g. carpal tunnel syndrome)
  • fractures, joint injuries and dislocations
  • tendinopathies (e.g. tennis elbow) and other soft tissue injuries
  • pain conditions
  • nerve and tendon injuries
  • burns and scar management
  • sporting injuries
  • work-related injuries
  • post-surgical conditions.

What happens at an appointment?

When you meet with an Accredited Hand Therapist, you’ll work together to develop a treatment plan. It will take into consideration your specific situation, symptoms, and the environment in which you live and work.

Some treatments aim to resolve a problem, for example, improving muscle strength or range of motion after a fracture. Some treatments may be preventive and involve teaching you to manage symptoms like pain or swelling in response to an injury or illness.

Assessments may involve specific measurements; for example, the therapist measures your wrist’s range of movement or grip strength. Assessments also include your experience of the problem, for example, when you describe the location of the problem, how your symptoms feel and affect you, and the things you noticed or experienced when you first noticed your symptoms.

Treatments often use heat, ice or electrotherapy to improve healing, orthoses (splints) to rest soft tissues (e.g. muscles, tendons, ligaments), and specifically targeted exercises to improve movement and strength.

You’ll be encouraged to complete a home program when possible, so education will also be a large part of your treatment.

To achieve the best outcomes, therapists may collaborate with other health professionals such as hand surgeons, rehabilitation consultants or GPs.

Where do I find an Accredited Hand Therapist?

Accredited Hand Therapists can be found throughout Australia in private practice (sometimes co-located with hand surgeons), in public hospitals and in community settings. In Australia, there are over 400 Accredited Hand Therapists in metropolitan, rural and remote locations. You can contact a hand therapist through the AHTA “Find an Accredited Hand therapist” web page or email the AHTA at enquire@ahta.com.au.

You use your hands all day long, so receiving the best care to recover after surgery, injury, or a medical condition is essential. Your hands deserve the best, and so do you!

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.


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10/Aug/2022

Creams, sprays, liniments, ointments, patches, rubs & gels

If you open most medicine cabinets or bathroom cupboards, you’ll more than likely find a tube or jar of a pain-relieving rub. With varying degrees of smelliness!!😱

Many of us turn to these products when we wake up with a stiff neck or overdo it in the garden. The soothing ointments, creams, sprays, liniments, patches, rubs and gels that we apply directly to our skin (topically).

But what are they? How do they work? Are they effective? And are they safe?

First, there’s a vast array of topical products available in many forms and using different ingredients. Many are available to buy over-the-counter from your chemist or supermarket. However, some require a prescription.

Let’s look at some of the more common varieties.

Counterirritants

These products use ingredients such as menthol, methyl salicylate, eucalyptus oil and camphor. They’re called counterirritants because they create a burning, cooling or ‘tingling’ sensation in the area where they’re applied that distracts you from your pain.

Medicated products

Many topical products contain non-steroidal anti-inflammatory drugs (or NSAIDs) such as ibuprofen, diclofenac or piroxicam. NSAIDs block the action of specific enzymes (cyclooxygenase or COX) that are involved in inflammation.

Topical NSAIDs may be an option for you if you can’t take oral NSAIDs due to other health issues (e.g. high blood pressure) or the risk of complications (e.g. stomach problems), as less medication is absorbed into the bloodstream.

If you’re using a topical NSAID, you should avoid taking NSAIDs orally (pills or tablets) unless you’ve discussed this with your doctor. Although the amount of medicine that enters your body through the skin is less than when taking them orally, there’s still the risk of getting too much when using both forms.

Corticosteroids, or steroids, simulate the naturally occurring hormone cortisol. One of the many functions of cortisol is to suppress or reduce inflammation. Steroid creams come in varying strengths. They rarely have serious side effects if used correctly, so it’s essential that you follow the instructions carefully. If you have any concerns, discuss these with your doctor or pharmacist.

Capsaicin

Capsaicin is the substance found in chilli peppers that gives them their heat and spicy kick, making your mouth tingle and burn. Applied to the skin as a cream, it works by interfering with the pain signals between your nerve endings and brain.

Benefits of using topicals

Most topicals, when used correctly, provide quick, temporary pain relief and have fewer potential side effects than oral pain-relieving medicines.

They may be a good option if you only have pain in a few joints or muscles, as they work in the immediate area you apply it to, rather than affecting your whole body.

Topicals also provide the soothing benefit of a mini-massage when you apply them to your skin. Seriously, how good does it feel when you rub the cream into your sore neck, and you feel the muscles loosening? Or when you apply a warm gel to your stiff, aching knee? Bliss. 😊

Another benefit of topicals is that they’re very portable; you can have some at home, in your drawer at work, in your handbag or gym locker, and use them as needed.

Do they work?

Many people swear by these products for quick pain relief. And there’s solid evidence that they can provide pain relief for acute pain, such as strains and sprains. However, research shows only modest benefits for chronic pain. But, if you feel better when using these products, and you’ve discussed it with your doctor, they’re safe to use and are better tolerated than oral medicines.

Potential side effects

Topicals, both medicated and non-medicated varieties, can cause side effects. They include skin irritation, redness, rash, or a burning, stinging or itchy sensation in the area it’s been applied.

Very rarely, some people may experience nausea, breathlessness, indigestion or an allergic reaction to the topical. If you experience any of these symptoms, stop using the topical and talk with your doctor or pharmacist for advice.

Cautions

As with any medication, there are things you need to be aware of to prevent any problems from occurring:

  • Taking oral and topical medicines containing the same ingredients (e.g. NSAIDs) at the same time may increase the risk of side effects. Talk with your doctor about this risk.
  • Always read the consumer medicine information carefully and follow the instructions. Take note of how to apply the topical, how often and how much. Don’t go overboard and slather it on. You can get too much of a good thing!!
  • Wash your hands thoroughly after applying.
  • Be careful to avoid contact with your eyes or other sensitive areas 😖.
  • Don’t use these products on wounds or damaged skin.
  • Don’t use with heat packs as this may cause burns.
  • Only use one topical medicine at a time.
  • Check the use-by-date and discard any out-of-date products.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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21/Jul/2022

COVID numbers are up and masks are back. The stupid virus and its many variants just keep on giving 😥.

We’ve dealt with isolations, lockdowns, and massive life changes in the past few years. We’ve made sourdough bread, completed countless jigsaws, consumed gallons of quarantinis (or was that just me? 😉🍸) and given online yoga a go.

But now what? Yoga has become a source of calm and relaxation, but we’re sick of sourdough, can’t bear to see another jigsaw, and for the sake of our livers, we’ve moved on to non-alcoholic mocktails (again, maybe just me? 🍹).

It’s time to cast aside the things that make us unhappy or trigger feelings of lockdown anxiety. It’s time to embrace the things we love, that make us fulfilled and satisfied. The things that feed our curiosity and creativity. And the things that support self-care.

Here are some simple things you can add to your routine to boost your happiness. Hopefully, one or two of them will strike a chord with you 😊.

Give thanks

Sometimes we can be consumed with what we don’t have or what others have… money, good health, the latest gadget, a great job, travel opportunities… Unfortunately, all this does is create feelings of envy or dissatisfaction – and that’s no way to live.

When I find these feelings creeping in, I stop myself. I think of three things I love about my life and make me grateful for the life I’m living. And there’s so much to choose from! My partner, the absolute love of my life 😍. Having a nice place to live in the green outer suburbs. A fabulous collection of shoes that I’m rediscovering after years of lockdown slippers and runners 😁 Psychotic balls of fluff (aka two cats) that rule my home and make me laugh. The fact that I live in a country where I can attend a non-violent protest for women’s rights. The chilli plant I bought as a small seedling that now produces deliciously hot chillies 🌶🌶 A library within walking distance. Without even breaking a sweat, that’s seven things I could list in a few short minutes!

We have lots to be thankful for in our lives – we just need to take a moment to think about and value them.

Learn new things

Nerd alert! For me, there’s nothing like watching a documentary, learning a new skill, attending a webinar/seminar/class, reading an article or talking with someone with unique experiences and knowledge. It always inspires me to discover more and delve deeper into a subject.

Learning new things challenges us and fires our curiosity and imagination. And that’s not only good for our mental health and satisfaction with life in general, but it’s also excellent for our brain health. I’m currently messing around with learning to play the guitar. I’m not sure if you could call the sound I create music, but it’s a lot of fun! If there’s something you’ve been wanting to learn, don’t put it off any longer. Book that class, take that online course, speak with people in the know – you won’t be disappointed!

Enjoy the company of friends and family

Seeing our important people face-to-face is all the sweeter when we remember the restrictions we endured in 2020 and 2021. It’s hard to imagine that there were periods when we could only connect via phone or video. So cherish the time you have together.

Do things for others

I find being useful and helping others a rewarding experience.

It doesn’t matter if it’s something small, e.g. letting a car into traffic in front of me, or something big, e.g. helping an aunt move into a retirement village, then out of a retirement village, and later relocate 500 kilometres away in the space of 18 months (true story 😝). To me, if it helps make someone’s life a little easier, it’s worth it.

There are many ways you can help out or do things for others, including volunteer work, mowing your neighbour’s nature strip, being kind to your barista, cooking a meal for a sick friend. Whatever you do, you’re sure to feel warm and fuzzy inside, and make your corner of the world that much brighter.

Laugh

Having a good laugh, chuckle or giggle is the best 😂😆🤣. Everything seems so much better, you feel happier, and you can’t wait to do it again.

Laughter releases the ‘feel-good’ hormones – endorphins, serotonin and dopamine. They boost your mood and make you feel more positive. And endorphins are your body’s natural pain reliever and can reduce your feelings of pain. Yay!

So next time you feel a little down, or you’re in pain, watch funny cat/dog/panda videos (I’ve heard there are a couple on the internet 😉), talk with a friend about a silly experience you had together, watch a comedy, listen to an entertaining podcast. Do whatever makes you laugh and enjoy those happy vibes.

Get out into nature

Whether it’s the local park, a walk on the beach or bushwalking through the hills, just getting out into nature makes me feel happy 🍁🍂. We’re surrounded by so much beauty.

When you head outdoors, keep your phone in your pocket and look around. Listen to the birds in the trees, notice how the trees sway in the wind, enjoy the dogs playing in the park, and appreciate the scenery around you. Take the time to pay attention and be mindful, and you’ll immediately feel a boost in your mood.

Discover new places

This often goes hand in hand with the previous one. And it’s something that kept me sane during lockdowns. I’d look at maps of my local area and the radius in which I was allowed to travel. I’d then look for all the green spaces – and it’s amazing how many parks, reserves, playgrounds, and abandoned golf courses I could find. When I visited them, I’d discover new, interesting things – a pretty creek alongside the path, a group of goats brought in to deal with the weeds, a flock of cockies gathered in a tree throwing seedpods at the people walking below 😆. Discovering new places brings out the intrepid explorer in me and I feel like I’m seeing so much more of the world.

Stay active

Activities that exercise your body and mind in challenging, new ways are great for your physical, mental and emotional wellbeing. And choosing activities that you enjoy will ensure you do them regularly.

For example, I’ve recently rejoined the gym because my strength and stamina have declined due to my sedentary COVID life. So I’m combining my usual walking and hiking with strength training, yoga and Pilates to increase my fitness, take some weight off my joints and help me sleep better. It’s early days, but I’ve already noticed a difference.

Like millions of others, I’ve also been enjoying the daily mental challenge of Wordle. It stimulates the brain and provides social competitiveness as we compare our wins and losses 😃. And I’m trying to learn to do cryptic crossword puzzles, though that’s proving more difficult!

The important thing is that I’m engaging both body and mind in demanding activities. They’re pushing me out of my comfortable status quo and making me grow.

Hug your people

Physical distancing and being unable to get close to others for fear of germs is a lonely experience. And it can leave us feeling sad at the lack of closeness. So the people I can touch, I touch a lot! Not in a creepy, unwelcome way 😄 but in a caring, loving way.

Being able to touch or hug others reduces stress, anxiety, and depression and makes us feel good. And here’s a tip from me to you: don’t save your hugs for when you’re feeling down. Hug each other when you feel happy, excited, or just because it’s Thursday.

Clean and declutter

Ooh, I did a lot of this during the first few lockdowns. And I know many of you did the same. Op shops were bursting at the seams with our discarded books, clothes, jigsaws and appliances. There’s nothing like decluttering and cleaning your home and work spaces to make you feel satisfied and in control. And your new tidy rooms will hopefully have the added benefits of preventing falls as trip hazards are moved or given away. Just be careful while doing your big clean not to overdo it physically. Take your time and pace yourself.

Try new recipes and new ingredients

Full disclosure, I’m a terrible cook. But I’ve been trying a new recipe and/or ingredient at least once a week. It gets me out of my ‘Tuesday night stir-fry’ rut. It helps to have tasty recipes from our talented volunteers, Lauren and Kitty. I’m also blessed that my partner is a great cook and has introduced me to spices and condiments I’ve never used before. There have been many, many disasters in the kitchen (and a trip to the hospital for a deep cut from slicing capsicums 😫), but there have also been successes. And that’s incredibly satisfying.

Acknowledge it’s been hard

So far, the things I’ve listed have been light and happy. But we should acknowledge that there have been dark, traumatic times without fun, joy or happiness. There have been tears, arguments, and moments of intense anxiety and stress. And before this pandemic is done, we’ll likely experience more of these moments. So it’s important to remember that we’re not going through this alone. We have people who love and care for us. We also have access to professional support if we need it to get through. We just need to ask.

The COVID-19 pandemic will pass. It’ll take some more time, but we can adapt. We’ve been doing it for years, and even though we’re weary, we can continue to do it. And finding the things that make you feel happy, strong, and in control of your world will help you get through.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

Contact Lifeline Australia

13 11 14 for 24 hour crisis support and suicide prevention.

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21/Jul/2022

Self-care is a trendy concept at the moment with many different definitions and uses.

You often see social media posts promoting self-care with pictures of day spas, yoga retreats and people exercising on the beach at sunset. All wonderful things, but when you live with a chronic condition, pain and sometimes-crippling exhaustion, life’s not always that glamorous!

So what is self-care?

The World Health Organisation defines self-care as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker”.(1)

That’s a pretty dry definition, so for the everyday person with a musculoskeletal condition, we describe self-care as the things you consciously and deliberately do to take care of your physical, mental and emotional health and wellbeing.

It includes everything from exercising regularly and staying active, eating a healthy diet, getting a good night’s sleep, caring for your mental healthmanaging pain and fatigue, seeing your healthcare team regularly, learning about your musculoskeletal condition, and staying connected with family and friends. It also involves good hygiene, avoiding risky behaviours and actions, and using medicines and treatments appropriately.

The International Self-Care Foundation (ISF) has developed seven pillars of self-care. They aim to help people understand the breadth and importance of self-care, and provide information about the steps you can take to care for yourself better.

Let’s explore them.

Pillar 1. Knowledge and health literacy

Knowledge, as the saying goes, is power – so understanding your body, how it works, how it’s affected by your musculoskeletal condition/s, as well as any other health conditions you have – gives you the ability to make informed decisions about your healthcare.

Health literacy refers to how we “understand information about health and health care, and how we apply that information to our lives, use it to make decisions and act on it”.(2)

Together, health literacy and knowledge give you the tools you need to actively manage your healthcare. By understanding your body and health, you can discuss your options with your health professionals, critically evaluate information from various sources, adjust your lifestyle and behaviours, understand risk factors, and the appropriate use of treatments and tests.

In fact, research shows that people who have high levels of knowledge and health literacy have much better health outcomes.

If you want to know more about your health and musculoskeletal condition/s, or you need help to improve your health literacy, there are many people who can help you.

Talk with your doctor and other members of your healthcare team. Contact the MSK Help Line and speak with our nurses. Visit authoritative websites (like ours).

And never be afraid to ask questions.

Pillar 2. Mental wellbeing, self-awareness and agency

Incorporating things you enjoy and that make you feel good into your daily/weekly routine – such as mindfulness, exercise, alone time, relaxation, massage, and staying connected with family and friends – is a simple thing you can do to look after your mental wellbeing and increase your resilience.

Self-awareness involves taking your health knowledge and applying it to your specific circumstances. For example, if you’re having problems sleeping, and you know exercise can help, you can ensure you’re getting enough exercise each day. Or if you’re carrying more weight than you’d like, and this is causing increased knee pain and self-esteem issues, talk with your doctor about safe ways you can lose weight. Or if you have rheumatoid arthritis and a family history of osteoporosis, talk with your doctor about how you can look after your bone health.

Agency is the ability and intention to act on your knowledge and self-awareness.

Pillar 3. Physical activity

OK, so this one’s fairly self-explanatory since we talk about the importance of exercise and being physically active all the time 😊.

Regular exercise helps us manage our musculoskeletal condition/s, pain, sleep, mood, weight, and joint health – and that’s just the tip of the iceberg! It keeps us moving, improves our posture and balance, helps us stay connected and helps prevent (or manage) other health conditions such as diabetes and heart disease.

Pillar 4. Healthy eating

This one’s also easy to understand, as along with exercise, healthy eating plays a vital role in our overall health and wellbeing.

Being overweight or obese increases the load on joints, causing increased pain and joint damage, especially on weight-bearing joints like hips, knees, ankles and feet. The amount of overall fat you carry can contribute to low but persistent levels of inflammation across your entire body, including the joints affected by your musculoskeletal condition, increasing the inflammation in these already painful, inflamed joints.

Being overweight or obese can also increase your risk of heart disease, diabetes, some forms of cancer, poor sleep and depression.

Being underweight also causes health issues. It can affect your immune system (meaning you’re more at risk of getting sick or an infection), and you may feel more tired than usual. Feeling tired and run down will affect your ability to be active and do the things you want to do.

If you need help to eat more healthfully or manage your weight, talk with your doctor or dietitian.

Pillar 5. Risk avoidance or mitigation

This pillar has the sexiest and most user-friendly title 😜😝.

Simply put, this pillar is about taking responsibility for your actions and behaviours. In particular, those that increase your risk of injury, ill-health or death.

To avoid these risks, you can drink alcohol in moderation, drive carefully, wear a seatbelt, get vaccinated, protect yourself from the sun, quit smoking, wear a helmet when riding a bike, and practise safe sex.

Seeing your doctor and healthcare team regularly is also important to stay on top of any changes to your health.

Pillar 6. Good hygiene

You’re probably wondering what this has to do with self-care for people with musculoskeletal conditions living in Australia. After all, most Australians have access to clean water and clean living/working spaces.

However, the last few years have shown how vital good hygiene is for protecting all of us from bugs and germs. It’s even more important if your condition or meds have weakened your immune system.

Practising good hygiene is a simple thing you can do to reduce the risk of getting sick or developing infections. So continue to regularly wash your hands, cough/sneeze into your elbow, stay home when sick, and keep your home/work environment clean. And although they’re not yet mandated in most places, wearing a mask is recommended and a really good idea when you’re indoors and can’t physically distance yourself from others.

All of these things will help maintain good health and avoid catching (or spreading) any nasties.

Pillar 7. Rational and responsible use of products, services, diagnostics and medicines

Another fun one! 😁 Although the title doesn’t roll of the tongue, this is an important pillar.

ISF calls these self-care products and services the ‘tools’ of self‐care, as they support health awareness and healthy practices.

They include medicines (both prescription and over-the-counter), aids and equipment (e.g. TENS machine, heat or cold pack, walking stick), health services (e.g. physiotherapy, massage therapy), wellness services (e.g. exercise classes, weight loss groups), and complementary therapies.

ISF also says that the use of these tools should be ‘rational and responsible’. That means only using safe and effective products and services.

“An empty lantern provides no light. Self-care is the fuel that allows your light to shine brightly.” – Unknown

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

References

(1) Self-care interventions for health, World Health Organization.
(2) Health literacy, Australian Commission on Safety and Quality in Health Care


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21/Jul/2022

Looking for ways to put more ‘care’ into your self-care game? We’ve got 21 tips to help you!

1. There’s no perfect or right way to practise self-care

The first tip, and I can’t stress this enough, is there’s no perfect or right way to practise self-care. Sure, we can talk about the International Self-Care Foundation’s seven pillars, and we can push exercise, healthy eating and hand washing until the cows come home 🐄 🐄 🐄. But, if those things don’t resonate with you, or you have other pressing issues vying for your attention (e.g. dealing with a case of painsomnia), you’re not going to care about our messaging on those topics. Or, at least not at the moment.

2. Choose your own adventure

This leads us to tip number two. Self-care is like a ‘choose your own adventure’ story. It’s unique to you, your life, your specific set of circumstances and your choices.

3. Create your toolbox

Knowing the basic elements or tools of self-care (see the seven pillars) means you can choose what you need to help you manage at specific times. It’s like having a trusty toolbox filled to the brim with info about exercise, smoking cessation, healthy recipes, pain management strategies, guided imagery scripts and massage oil. You can pick and choose what you want or need. The key is knowing what’s available and how they can help you.

So far, we’ve been talking broadly about self-care. Now let’s look at some more specific tips our consumers and staff recommend.

4. Drink water

It lubricates and cushions your joints, aids digestion, prevents constipation, keeps your temperature normal and helps maintain your blood pressure. The amount of water you need varies from person to person and from day to day. There’s no ‘one size fits all’, but “as a general rule, men need about 10 cups of fluids every day and women need about 8 cups (add another cup a day if you are pregnant or breastfeeding)”. (1)

5. Plan your menu

You can take a lot of the stress out of your day if you sit and plan your week’s meals and snacks. Check what ingredients you have in your pantry, fridge and freezer, work out what you need to buy, and write it all down. Then all you hopefully need is one trip to the shops, and you’re sorted! No more – ‘what’s for dinner’ angst. 😐 Eatforhealth.gov.au has some info on meal planning and sample plans for men, women and children.

6. Get excited about exercise

Mix up your exercise routine with something fun and enjoyable to get you out of your exercise rut. Try Zumba, cardio, low-impact exercises, tennis, dancing, skipping, cycling, or trampolining. Head to your local fitness centre or gym, try an online class or download an app like Get Active Victoria. There’s something for everyone!

7. Just breathe

Our breathing can become shallow when we feel stressed, anxious, upset or in pain. This, in turn, can elevate blood pressure and increase the heart rate. It can also cause more tension. When you notice this happening, take some time to decompress. Relax your body. Focus on your breathing. Slowly take a deep breath in. Fill your lungs to a capacity that’s comfortable for you. Then slowly release this breath. Don’t release it in a sudden exhale, but control it, so it’s slow and smooth. Continue this deep breathing, and you’ll feel your muscles relax, and your mind calm.

8. Write it down

Write about the things that make you happy and grateful. Write about the things that went well in your day.

And write about the bad things. Not so you’ll continue to obsess about them, but so you can process your feelings and actions. This reflection allows you to devise strategies to prevent the bad thing from happening again, or ways to handle it differently in the future.

9. Fill your home with plants

Bring the outdoors in and enjoy the health benefits. Having plants in your indoor spaces can help relieve stress, improve mood, lower blood pressure and improve air quality. Just be sure to check that they’re not toxic for you, your family or your furry housemates. 🌼

10. Have a regular date night

Whether with your significant other or a bestie, having a regular date night scheduled gives you something to look forward to. It also means there’s less chance that other commitments get in the way of you spending dedicated time with that person, which is essential for nurturing your relationship. 🧡💚💛

11. Say no

We all want to please others, so saying no can be challenging. But you need to weigh up everything you have going on and decide whether you can take on something else. If you can’t, then say no. And don’t feel you have to apologise for doing so.

12. Discover new places

Embrace your inner adventurer and explore new places. Far or near – it doesn’t matter. The point is to get out in the world and experience new sights, sounds, smells and tastes. Immerse yourself in new experiences.

13. Listen to music

Music is a powerful force we often don’t think about – or at least not too deeply. It’s always there, often in the background. But music can improve your mood, help you focus, get motivated and even ease your pain. Find out more about the power of music.

14. Pat your pets

Spending time with your pets is a wonderful tonic. It can decrease blood pressure, reduce feelings of loneliness, reduce stress, improve your mood and increase opportunities for exercise and outdoor activities. And they’re so much fun! 🐶😺

15. Get tidy and organised

Nothing can make you frazzled faster than not being able to find that ‘thing’ you’re looking for. So taking time to put things away in their place after you’ve used them, or reorganising your cupboard/pantry/child’s room, so that things are orderly and easy to find can bring a lot of calm to your life. The level of order you want to achieve is up to you. Although there are MANY social posts about the perfectly organised home, don’t fall down that rabbit hole. All you need to achieve is a space that makes you feel good and suits your lifestyle.

16. Eat mindfully

How often have you eaten dinner but can’t remember what it tasted like because you were watching TV? Or wondered how on earth you ate a whole packet of potato chips while scrolling through Insta? If this sounds familiar, try some mindfulness. You may have tried mindfulness meditation, but you can also be mindful when you do other activities, like eating. It simply means that you focus on the moment and the activity without being distracted. So when you’re eating, really take time to focus on the textures, smells and flavours and how the food makes you feel.

17. Get your meds sorted

Medicines are an important part of our self-care, but it’s easy to miss doses, get them mixed up with others meds or take them at the wrong time. So have a chat with your pharmacist. Ask questions about your medicines and supplements, so you’re fully informed about each one.

Many pharmacies have apps you can download that alert you when you need a new script, or you can download the MedicineWise app from NPS. If you take lots of medicines, or you find it hard to keep track of whether you’ve taken them or not, consider using a pill dispenser. You can buy one and fill it yourself, or your pharmacist can do this for you.

18. Listen to your body

Living with a chronic condition means that you need to be self-aware of how you’re feeling. If you’re exhausted, rest. If your back’s stiff, move. If you’re feeling sluggish, get some fresh air. If you’re feeling full, stop eating. Whatever your body is telling you, listen and take action.

19. Treat yourself

Many self-care posts we see on socials are very much of the ‘treat yo’ self’ variety. Going to a day spa, enjoying decadent foods, doing some online shopping, getting a pedicure, binging a favourite TV series, or travelling to exotic places. And why not? Why not indulge in pleasurable things that make you happy every now and again? As long as you’re not overindulging, overspending or overeating. Find the right balance and treat yourself. 😍

20. Stand up

We spend so much of our time sitting. In the car, on the couch, at the office, in waiting rooms. But we know that too much sitting can be bad for our health. It increases the risk of developing heart disease, type 2 diabetes and some forms of cancer. It also makes us feel tired, and our muscles and joints become stiff and sore from inactivity. So stand up and move regularly. Set alerts on your phone to remind you. Or download the Baker Heart and Diabetes Institute Rise & Recharge app, which helps reduce sitting time and encourages regular movement.

21. Play

We loved to play when we were kids. Chasing each other, making up games, not overthinking things and just having fun. But as adults, we become too busy for play. Or we feel silly or self-conscious about how we might appear when we play. But playing is fun! It helps us forget about our work and commitments. It lets us be in the moment and let our inhibitions go. Play relieves stress and allows us to be creative and imaginative. So rediscover playing – with your kids, pets, partner, and friends. Let your inner child loose, play and have fun! Rediscover chasey (the dogs love that one), play hide and seek, build a blanket fort in your lounge, throw a Frisbee, play charades, the floor is lava, or a video game tournament. There are no rules – just have fun!

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

Reference

(1) Drinking water and your health, Healthdirect


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07/Jul/2022

Pilates, yoga, and tai chi

How’s your exercise routine going? Are you doing the amount of activity recommended in the Australian physical activity and exercise guidelines?

As a reminder, the guidelines say that adults should be active most days, preferably every day.

Each week, adults should do either:

  • 2.5 to 5 hours of moderate-intensity physical activity – e.g. a brisk walk, golf, mowing the lawn or swimming
  • 1.25 to 2.5 hours of vigorous-intensity physical activity – e.g. jogging, aerobics, fast cycling, soccer or netball
  • an equivalent combination of moderate and vigorous activities.(1)

I know I’m meeting these recommendations, but like me, are you finding that exercise has become a little dull? Has your exercise routine been reduced (because of COVID fears and restrictions 😷) to simply walking? Lots and lots of walking 🚶 🚶 🚶?

Although I love a good walk, it isn’t working my body as much as it needs to be worked for optimal health and wellbeing. So while I’ll continue doing it, it’s time to add something new … something that will also improve my fitness, stamina, balance and flexibility.

And now’s the perfect time. Even though it’s cold and wintery, many of these exercises can be done indoors, where it’s cosy and warm.

Before we go any further, what are low-impact cardio exercises?

Simply put, low-impact exercises or activities are easy on your joints. They put little or no impact on them – hence ‘low-impact’. Examples include swimming, cycling, tai chi and yoga. While doing these exercises, you’re putting minimal stress, weight, or pressure on your joints.

Compare these activities to more intense ones such as running, basketball or tennis. They aren’t low-impact because your joints are being jarred or impacted by the activity. For example, your hips, knees and feet feel the impact when you run, and your arm, shoulder and wrist feel the jarring as your return a tennis volley.

The ‘cardio’ aspect means that while you’re being kind to your joints, you’re still getting a workout. Cardio exercises increase your heart rate and improve the health of your heart and lungs (or your cardiovascular system).

What are the benefits of low-impact cardio exercises?

These exercises allow you to stretch and strengthen your muscles without putting your joints through too much stress. They’re also a great place to start if you’re a beginner, haven’t exercised in a while, or you’re recovering from an injury.

Low-impact exercises can also improve flexibility, mobility and help relieve joint pain and stiffness. Because you’re getting a solid workout, the exercise builds endurance and stamina, aids weight loss, helps reduce your risk of other health problems (e.g. diabetes) and can improve your sleep quality.

Regular exercise improves your mood and mental health. It also improves your balance and can reduce your risk of falls, which is essential if you have osteoporosis or are at risk of poor bone health.

Let’s look at a few low-impact exercises that will provide a good workout but, when performed correctly, won’t aggravate musculoskeletal conditions.

Tai chi

Tai chi is an ancient form of martial art originating in China. It’s evolved over centuries into what’s been called ‘moving meditation’ because it combines gentle, flowing movements with mindfulness and deep breathing.
It’s a low-impact, slow-motion exercise with specific controlled movements. When doing tai chi, your muscles are relaxed rather than tensed, and your joints aren’t fully extended or bent.

There are many forms of tai chi, and some have been modified to suit people with various health conditions, including arthritis and osteoporosis.

Tai chi promotes correct body posture and balance, improves flexibility and integrates the body and mind. It’s practised by people of all ages and fitness levels.

You can learn tai chi online or from books or DVDs, but most people find it easier to learn from a qualified instructor. They’ll ensure you’re performing the movements correctly and safely.

The Tai Chi for Health website has a search function to help you find a qualified tai chi instructor in your area.

Online recordings, books and DVDs are useful to help you practice between classes. Your instructor will be able to recommend some websites and titles.

Yoga

Like tai chi, yoga incorporates mind, body and breath. Yoga originated in India over 5,000 years ago. Since then, it’s become incredibly popular around the globe.

It’s so popular that it’s all over Insta, TikTok, Facebook and YouTube. But take what you see on these platforms with a grain of salt. They often show us the extremes of yoga – fit and flexible people bent and twisted into challenging poses. This can be a little off-putting 😮!

The good news is there are many different types of yoga to suit all needs and interests. There are even types of yoga that have been modified so that you can use a chair, a block or other aids to help you do the postures without straining your joints or aggravating your condition. So if you’re interested in trying yoga, you’re sure to find a type that suits you.

Search the Yoga Australia website for a qualified yoga teacher. When making contact with them, ask about the type of yoga they teach, whether it’s suitable for people with your condition (and any other health conditions you have) and if they’ve successfully taught people with your condition before.

Pilates

Pilates was developed in the 1920s by German physical trainer Joseph Pilates. It focuses on postural alignment, strengthening the trunk (your abdominals, hips, inner and outer thighs, and back), body awareness and breath control. Initially, it was dancers, athletes and soldiers who used Pilates to strengthen their bodies and recover from injury.

However, it didn’t take long for Pilates to become popular amongst the wider community. Pilates’ slow, controlled movements are suitable for people of all ages, fitness levels and abilities.

Pilates can be performed on a mat or using special equipment (e.g. the Reformer) in a Pilates studio. The difference is that mat Pilates uses only your body weight and gravity as resistance, whereas the equipment involves springs, ropes, and straps for added resistance. Depending on your needs and preferences, you can choose to do Pilates on a mat at home or in a class environment, or in a studio using equipment. Or you can do both, as Joseph Pilates intended.

Ensure you see a qualified instructor who can teach you how to perform each exercise correctly and safely.

You can find a Pilates instructor via the Pilates Alliance Australasia or the Australian Pilates Method Association.

Health insurance

In 2019, the Australian Government made changes to private health insurance. Many natural therapies are no longer covered by your extras, including Pilates*, tai chi, and yoga.

With no rebate available, this will affect your out-of-pocket costs, so when making inquiries about classes or sessions, ask for prices 💰.

*Note: Clinical Pilates, delivered by a physiotherapist, is covered under physiotherapy care as part of your extras cover without any changes.

Starting classes

If you decide to try Pilates, yoga and/or tai chi, there are a few things you should do:

  • Talk with your doctor about whether these exercises are suitable for you. Discuss any potential benefits and risks.
  • When inquiring about classes, ask if your instructor is qualified and if they’ve worked with people with musculoskeletal conditions.
  • Ask how much the classes/sessions cost and how often you need to attend.
  • Don’t rush through the warm-up and cool-down – they’re important for preventing injury and pain.
  • Focus on your movements and technique to ensure you’re exercising correctly and safely.
  • Listen to your body. Some pain is expected when you begin exercising your body in a new way, but it shouldn’t be severe. Stop the exercise and discuss it with your instructor if you feel unusual pain. You may be performing the exercise incorrectly, or need to modify it to suit you.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

Reference

(1) Physical activity and exercise guidelines for all Australians: For adults (18 to 64 years)
Australian Government, Department of Health and Aged Care


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07/Jul/2022

Guest blog by hand therapist Catherine Reid, B.App. Sci, (OT), M.Sci (H&UL rehab), MAHTA (As awarded by the AHTA), CHT

The advent of COVID has seen many more people riding their bikes, either for exercise or for their daily commute. It’s a great exercise for the heart and lungs and a low-impact exercise for people with musculoskeletal conditions.

In recognition of the health and environmental benefits of riding a bike, the United Nations declared June 3rd to be World Bicycle Day. Unfortunately, as a hand therapist, I frequently hear patients complain that hand and upper limb pain or weakness limits their ability to ride.

Hand therapists are experts in rehabilitating the upper limb. We understand anatomy and how it relates to everyday activities. We can help determine what’s causing the problem, if it’s due to an injury, illness or activity, and provide appropriate treatment.

Some pain experienced when riding a bike may be due to vibration transmitted up through the bike into the arms or due to the prolonged time or force with which the handlebars are gripped.

If you love to ride but find it a bit painful, here are my top 10 tips for protecting your hands and upper limbs while riding. The best place to start is from the ground up.

1. Tyres

If you’ve ever ridden a bike or billy cart with solids tyres rather than rubber, air-filled, pneumatic tyres, you know what a difference a little air and rubber can make!

Yet even with pneumatic tyres, vibrations or jolting through the handlebars can be painful for people with arthritis or joint injury. Ensuring the tyres on your bike are properly inflated can help reduce stress going up through the arms and into your body. The current thinking in the biking world is that wider tyres with less pressure offer better rolling resistance and comfort.

Wheels for bikes can also vary in stiffness depending on the design and the material they’re made from, so some are better at absorbing shock than others.

2. The frame

If you plan to explore the world and take your bike with you, you need to consider the weight of your bike. Is the weight manageable for you?

And when choosing a bike rack, one mounted on the back of the car might be an easier option than lifting your bike over your head onto the roof of a car. Lower lifts reduce the strain on sore or stiff shoulders.

Carbon fibre and titanium bikes are much lighter than traditional steel-framed bikes but come at a cost.

Another consideration is that the further away your seat is from the handlebars, the more of your weight your arms will be supporting.

3. Shock absorbers

The front fork of a bike can have shock absorbers that reduce the force going up into your arms from uneven terrain while keeping the tyres in contact with the ground for better control. They can be easily adjusted to provide more or less bounce.

4. Stem flexibility

The stem attaches the handlebars to the bike, and the modern stems have pivots, elastomers and moving parts to provide suspension. They may be as effective at smoothing the force from rough terrain as the fork suspension but may be a cheaper option to retrofit to a bike.

5. Handlebar shape

There’s a huge variety of handlebar shapes, which roughly fall into three categories: swept back, drop or flat handlebars. Some of the handlebars offer several different grip positions enabling the rider to vary their grip.

For example, the drop bars enable the rider to use three different positions

  • the hooks, the part that curves or drops down, taking most of the weight through the hand;
  • the hoods are the rubber covers around the hinges of the levers. For smaller hands, it might be more comfortable holding the levers here, but there’s some loss of strength as the grip is near the hinge and not the end of the lever;
  • the third place you can hold a drop bar is on the top of the bar. This gives the rider a more upright position and places the hands in a palm down position, but this is a less anatomically friendly position for the wrist. Placing hands in a palm down position also puts pressure on the nerves in the palm of the hand, which can cause compression neuropathies such as carpal tunnel syndrome or cyclist’s palsy. Carpal tunnel syndrome affects the thumb side of the hand, while Bicycler’s neuropathy affects the little finger side; both conditions cause numbness and tingling in the hand.

6. Handlebar rise and sweep

Handlebar rise is the vertical rise measured from the centre of the bar to the bar end. The handlebar height can be adjusted by raising the stem or by increasing the rise of the handlebars. Increasing the rise changes the body position of the rider to a more upright position, meaning more weight is placed through the saddle, and less weight is placed through the shoulders, wrists and hands. Handlebars can have an upsweep and a backsweep. Sweep is the angle from the stem to the end of the bar either in an upward angle (upsweep) or in a backward angle (backsweep). More upsweep generally places more pressure on the hands, wrist and shoulders, whereas more backsweep places the wrists in a more natural (palms facing) position.

7. Handlebar material

The material the handlebars are made of can affect their ability to reduce or dampen the forces going through them. Carbon fibre and aluminium dampen vibrations better; however, steel and titanium flex. A little bit of flex in a handlebar is a good thing as it absorbs some of the force from bumps in the road.

There’s also a line of handlebars that have a foam-filled core to deaden the vibration through the core.

8. Grips and tapes

Larger grips generally distribute the weight more evenly through the hand. There are lots of commercially available grips, and many can be retrofitted to your bike.

Some change a flat handlebar to provide a vertical grip as well, allowing for a change of hand, wrist and elbow position. This can help reduce hand stiffness and provide rest from pressure on a particular joint or nerve. Tapes can either be gel or cork. The advantage of cork tapes over gel is that they don’t compress over high-pressure areas and are generally more durable.

9. Gloves

Gloves offer added protection from blisters and falls and improve grip. Glove fit should be firm so they don’t bunch up and cause pressure areas. They should also fit firmly around the cuff so water can’t leak in when it’s raining.

Keeping hands warm with waterproof or thermal gloves helps maintain hand dexterity, especially for arthritic hands. Lightweight, breathable summer gloves with wicking ability may be helpful to reduce sweaty palms, which reduce grip.

Some gloves have padding to reduce vibration, which irritates the nerves of the hand, or silicon tips or open tips to improve touch.

Gloves can provide skin protection in the case of a fall or protection for mountain bikers with inbuilt carbon fibre inserts to protect the backs of the hands from trees.

10. Gears and brakes

Traditionally gears fall into 3 categories:

  • Twist or grip shifters,
  • Trigger shifters, or
  • Shimano Total Integration (STI) brake lever shifters.

More recently, digital computerised gear mechanisms have been introduced. They require very little resistance to use, but unfortunately, they’re expensive to retrofit to your bike.

Twist shifters can only be fitted onto straight handlebars and are controlled by rotating the wrist. They’re easier on the fingers and the thumb as wrist motion is used to control the gears. So if you have painful fingers or reduced dexterity, twist gears might be advisable. Twist shifters are known to become stiffer over time, which might put undue strain on the wrist. They also require frequent repositioning of the wrist.

Trigger shifters generally require little force and can be activated with different fingers. To shift gears, the top lever is moved with the fingers, and the bottom lever is moved with the thumb. The benefit of trigger shifters is that the wrist stays in a neutral position. This is helpful if you have tennis elbow as it reduces strain in the muscles at the elbow joint.

STI Brake lever shifters are a combination of the gear shifter and the brake lever on the one fitting. This allows the rider to shift gears without moving their hand from the bars. They’re generally found on touring or racing bikes and can be activated while holding the hoods. They require minimal force to use.

Brakes can either be hydraulic or cable brakes.

Hydraulic brakes are preferable if you have upper limb problems as they take far less force to use. The back pedal (coaster) brakes are less common these days and are generally found on cruiser bikes or kids bikes. They’re worth considering if you have poor eye-hand coordination or poor hand strength. If the levers are too far out from the bars, people with smaller hands have difficulty reaching their fingers around the brake levers, making it difficult to grip forcefully. This can be adjusted with small rubber inserts placed at the hinge end of the brake lever.

Getting your bike tailored to meet your specific needs may just require some minor changes to your existing bike. But sometimes, purchasing a new bike can be more cost-effective. Remember, changing any part of your bike will affect your bike’s fit and may affect your bike’s handling. It’s worth getting your existing bike correctly fitted to you before making too many expensive changes.

If changing your bike isn’t helping, then you need to see a hand therapist to evaluate the cause of the pain and, if needed, provide upper limb exercises, treatments or supportive splints to enable you to keep riding. A hand therapist in your local area can be found on the Australian Hand Therapy website.

Our guest blogger Catherine Reid is an occupational therapist with a Master of Science in Hand and Upper Limb Rehabilitation. She’s a full member of the Australian Hand Therapy Association and works in her private practice Western District Hand Therapy, in Warrnambool, Victoria.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

 


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07/Jul/2022

It’s definitely a mouthful, but what is axial spondyloarthritis?

Axial spondyloarthritis (axSpA) is the umbrella term for two different types of inflammatory arthritis that affect the spine: ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)

Ankylosing spondylitis (AS) affects the spine and the joints that connect the lower spine to the pelvis (sacroiliac joints). These changes are visible on x-ray.

In non-radiographic axial spondyloarthritis (nr-axSpA), these changes aren’t yet visible on an x-ray but may be seen on an MRI. For some people, nr-axSpA will never progress to the stage where joint changes are seen on x-ray. For others, these changes will eventually be seen on an x-ray, and their diagnosis will be changed to AS.

These conditions cause pain, stiffness and reduced mobility in your spine. They can also cause symptoms including inflammation of tendons and ligaments, inflammatory bowel disease, psoriasis and inflammation of the eye.

The good news is that axSpA can be treated effectively with medicine and self-care.

Q. What are the signs that I may have axial spondyloarthritis?
A. The signs or symptoms of axial spondyloarthritis vary from person to person. The most common symptoms are pain and stiffness in the back, often the lower back and into the buttocks that:

  • comes on gradually over weeks or months
  • is worse in the second half of the night and wakes you up
  • is worse first thing in the morning, with early morning stiffness that lasts 30 minutes or more
  • is worse after rest and feels better after activity and exercise
  • has been present for 3 months or more
  • may involve pain deep in the buttock that can swap from one side to the other over time, especially in the early stages (doctors call this ‘alternating buttock pain’).

Other symptoms can include:

  • fatigue (extreme tiredness)
  • inflammation and pain in tendons (which connect muscles to bones) and ligaments (which connect bones to each other), which you may feel as pain in the front of your chest, back of your heel or underneath your foot
  • arthritis in one or more of your peripheral joints – such as the joints in your hands, feet, arms or legs
  • inflammation in your eye (uveitis)
  • inflammatory bowel disease
  • psoriasis
  • feeling feverish and having night sweats
  • losing your appetite and losing weight.

Symptoms may change from day to day. At times your symptoms (e.g. pain, fatigue, inflammation) can become more intense. This is a flare. Flares are unpredictable and can seem to come out of nowhere.

Q. What causes axial spondyloarthritis?
A. Axial spondyloarthritis is an autoimmune disease. That means it occurs as a result of a faulty immune system.

Instead of identifying foreign bodies (e.g. bacteria, viruses) and attacking them to keep you healthy, your immune system mistakenly targets healthy tissue in and around your joints, causing inflammation and pain.

We don’t know why this happens. Genes are thought to play a role. You’re more likely to get axSpA if you have a history of it in your family. Most people with axSpA have the gene called HLA-B27; however, this gene can also be found in people who don’t have axSpA.

Since this gene doesn’t automatically lead to the development of axSpA, other factors are thought to be involved.

We used to think axSpA affected more men than women, but recent research suggests men and women are affected relatively equally.

Q. How do I know if I have axial spondyloarthritis?
A. If you have ongoing back pain and stiffness or other symptoms of axSpA, it’s essential that you see your GP. Getting a diagnosis as soon as possible means that treatment can start quickly. This will give you the best possible outcomes.

No one test can diagnose axSpA, so your doctor will use a combination of tests to confirm your diagnosis. They may include:

  • Your medical history. Your doctor will ask about your symptoms, family history and other health issues.
  • A physical examination to assess joint tenderness, flexibility, and stiffness.
  • Blood tests to check for inflammation associated with axSpA.
  • Genetic testing to look for the HLA-B27 gene, which is present in most people with axSpA.
  • Scans such as an x-ray and MRI (magnetic resonance imaging) to look for joint inflammation and damage.

Your GP will refer you to a rheumatologist if they think you have, or have diagnosed you with axSpA. Rheumatologists are doctors who specialise in diagnosing and treating problems with joints, muscles, bones and the immune system.

Q. How is axial spondyloarthritis treated?
A. Your rheumatologist will recommend and prescribe medicines for your axSpA.

The two main types of medicines used to treat axSpA and help manage its symptoms are NSAIDs and targeted therapies:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) are nearly always used as the first medicine to treat the pain, inflammation and stiffness of axSpA unless there’s a reason that you can’t take them. Research shows that NSAIDs are very effective in managing symptoms of axSpA. Some people may need to take them regularly, while others will only take them as needed. This will depend on your symptoms and how you respond to the NSAID. Your rheumatologist will talk with you about how often you should take NSAIDs and the long-term benefits and risks of using them. There are many different types and brands; some are available over-the-counter, while others are only available on prescription.
  • Targeted therapies are medicines that ‘target’ specific proteins in the immune system that produce inflammation. They include biological disease-modifying anti-rheumatic drugs (biologics), biosimilars and targeted synthetic disease-modifying anti-rheumatic drugs. These targeted treatments have dramatically improved the quality of life for people with axSpA who need more than NSAIDs to manage their condition. They work to control your immune system in a targeted way, slowing down the attack on your spine and joints. Your rheumatologist will talk to you about using these medicines if you need more than NSAIDs to manage your axSpA or you’re unable to take NSAIDs.

Q. What can I do to control my symptoms?
A. As well as taking your medicines as prescribed, there are things you can do.

  • Learn about your condition. Understanding axSpA allows you to make informed decisions about your healthcare and actively manage it.
  • Exercise regularly. This is the most important thing you can do to help manage your axSpA. Exercise can improve symptoms including stiffness, pain, fatigue, breathing capacity and posture. It helps increase your flexibility and range of movement, so it’s easier to do many everyday tasks. As soon as possible after receiving your diagnosis, you should ideally begin a personalised exercise program developed by a physio or exercise physiologist (EP) and aim to do some exercise every day. Being active is also essential for your overall health and wellbeing. It helps keep your muscles, bones and joints strong so that you can keep moving. It reduces your risk of developing other conditions such as heart disease, osteoporosis, diabetes and some forms of cancer. It boosts your mood, benefits your mental health, helps with weight control and improves sleep.
  • Manage your weight. Being overweight or obese increases inflammation throughout your body. This inflammation affects not only your joints but also blood vessels and insulin levels. This can increase your risk of chronic health conditions such as heart disease and diabetes. Losing weight is an important thing you can do to reduce your risk of these conditions and to reduce your axSpA symptoms. Being overweight or obese also limits the effectiveness of some medicines used to treat axSpA. Losing weight can be challenging, so if you need to lose weight or advice on healthy eating, talk with your doctor or dietitian.
  • Learn ways to manage your pain. Pain is the most common symptom of axSpA, so learning to manage it effectively is crucial. Read our A-Z guide for managing pain for more information.
  • Work closely with your healthcare team. The best way to live well with axSpA is by working closely with the people in your healthcare team (e.g. GP, rheumatologist, physio). Keep them informed about how you’re doing and if you’ve experienced any changes in your symptoms or tried new medicines, complementary therapies, supplements or other treatments.
  • Use aids and equipment. Supports such as long-handled shoehorns, reachers and canes can reduce joint strain and make life easier, especially if your condition has reduced your flexibility and mobility. An occupational therapist can advise you on aids, equipment and home modifications. You can also check out our range of aids in our online shop.
  • Sleep well. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have axSpA and chronic pain can be difficult. If you’re having problems sleeping, talk with your doctor about ways you can address this.
  • Manage stress. Stress can also aggravate your symptoms, so learning to deal with stress is extremely helpful. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques such as going for a walk, getting a massage or listening to music, and, where possible, avoiding people and situations that cause you stress.
  • Practise mindfulness. Regularly practising mindfulness meditation can improve your mood, relieve stress, improve sleep, improve mental health and reduce pain.
  • Eat a healthy, balanced diet. While there’s no specific diet for axSpA, it’s important to have a healthy, balanced diet to maintain general health and prevent weight gain and other health problems, such as diabetes and heart disease.
  • Quit smoking. Smoking cigarettes is not only bad for your general health but also negatively affects your bone health and increases inflammation.
  • Seek support from others. You might find it helpful to contact Ankylosing Spondylitis Australia or the Ankylosing Spondylitis Group of Victoria and speak to others who have axSpA and know what you’re going through.

Q. Are there any complications I should be aware of?
A. Some people living with axSpA develop an eye problem called uveitis, which causes a painful red eye with blurred vision and sensitivity to light.

If you develop eye symptoms, you’ll need to quickly get your eye checked and treated by an ophthalmologist. Treatment is usually with prescription eye drops, which reduce the chance of permanent eye damage.

By understanding this risk and knowing what signs to be alert for, you can reduce the risk of damage to your eyes.
Ask your GP or rheumatologist what you should do if you develop any eye symptoms.

Q. What about surgery?
A. Most people with axSpA can manage their condition using a combination of exercise, medicines and self-care.

However, surgery may be considered in some cases if treatments haven’t provided relief from symptoms or if you have a spinal fracture or dislocation. Surgery that may be considered includes:

  • hip arthroplasty (replacement) surgery if you have severe and persistent hip pain
  • cervical fusion, where bones in the cervical (upper) spine are fused together to treat a fracture or dislocation
  • wedge osteotomy removes a wedge-shaped piece of bone from a vertebra to allow the spine to be realigned.

If your doctor thinks surgery might be an option, they’ll refer you to an orthopaedic surgeon. Together, you can discuss the benefits and risks of surgery and decide if it’s right for you. If you’re unsure about surgery or don’t feel comfortable with the information from the surgeon, ask your doctor to refer you to another surgeon for a second opinion.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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16/Jun/2022

Times are tough; there’s no denying that. The rising costs of everything (hello, $10 iceberg lettuce 😭) are putting the household budget under significant pressure. And this is causing many of us to feel anxious.

But we can do many practical things to relieve some of this stress. Let’s start in the kitchen with our tips for enjoying tasty, healthy meals and snacks that won’t cost an arm and a leg.

Make a meal plan – and stick to it

Before hitting the shops, plan your meals and snacks for the week. Check the fridge and pantry to see what ingredients you already have, and write a list of those you need. Writing a list is essential because, even if you’re not in pain or dealing with brain fog, it’s easy to forget things, buy the wrong quantities or items you don’t need in the heat of the moment. (Step away from the chips Lisa 😁). And if, like me, you hate shopping and really want to avoid crowds and germs, getting the shopping done quickly and efficiently is a must. With the steep price of petrol, it also makes sense to keep the trips to the shops to a minimum. So plan, plan, plan! Eatforhealth.gov.au has some helpful information on meal planning, including sample mean plans. There are also lots of meal planning apps you can download from Google Play or the App Store. They conveniently place your meal plan and shopping list on your phone, so no more forgotten shopping lists!

Read the nutrition panel

It’s a good habit to get into so you can track the amount of energy (kilojoules), fat, salt, sugar etc., in your foods. It’s also helpful when comparing different brands of the same product.

Swap some meat dishes for vegetarian or vegan meals

Research has found that vegan and vegetarian diets cost less than a diet that includes meat. You don’t have to go all-out vego; simply swap some of your meat dishes for plant-based meals. They’re tasty, healthy and cheap. Healthy vegetarian protein sources include tofu, chickpeas, beans, quinoa, lentils, eggs and nuts. If you need help, there are many websites with interesting and tasty vegetarian and vegan recipes.

Note: You’ve probably noticed the multitude of plant-based ‘meats’ crowding the shelves in your supermarket, often alongside actual meat products. They’ve been developed to look and taste like meat and can be a good alternative to meat, especially if your family aren’t keen on giving tofu a go 😉! Just make sure you read the nutritional panel carefully before buying these products, as some have high levels of salt, saturated fat and other additives. The Cleveland Clinic has an interesting article to help you know what to look for when buying faux meats.

Choose generic, home brand and no-name products

They’re generally cheaper and are often exactly the same as the name brand, just without the fancy packaging.

Prepare some meals in advance

When you’ve got some free time, make extra meals that you can freeze and use when necessary. That way, when you’re exhausted, having a flare, or just can’t be bothered cooking, you’ll have some meals you know are healthy. And you won’t have to resort to takeaway foods or store-bought frozen meals, which can be costly and are often high in fat, salt and/or sugar.

Buy local and in-season fruit and veg

They’re generally more nutritious, fresher and more cost-effective. The Australian Farmers’ Markets Association has a tool to help you find your local farmers’ market, and Sustainable Table has a handy seasonal produce guide.

Buy so-called ‘ugly’ produce

These fruits and vegetables are cheaper and taste fine. Who cares if your carrot has two ‘legs’ or your apple has a spot? At the end of the day, they’re perfectly healthy and packed with all the usual nutrients. They just don’t look shiny and new, but who does these days 😉? You can get imperfect produce at many supermarkets and food subscription services.

Read the unit price when comparing products

This will enable you to see the price difference regardless of brand or quantity, and you can work out which provides the best value for money. Unit pricing works by using a standard measurement across all products of the same type.

So, for example, if you compared yoghurt A with yoghurt B:

  • yoghurt A costs $6.40 for 1kg, so its unit price is $0.64 per 100g
  • yoghurt B costs $2.30 for 200g, so its unit price is $1.15 per 100g.

That makes yoghurt A cheaper per 100g.

Fortunately, you don’t have to do the mental gymnastics to work this out for yourself. The unit price is generally provided on the shelf label and online. Phew! Shopping is hard enough!

Grow your own

Over the past few years, many of us have discovered the joy of gardening. So why not grow some of your own produce? Whether on a small scale with a few pots of herbs on your balcony or larger scale vegie patch and fruit trees in your backyard, you can experience the pleasure and reap the rewards of growing some of your own foods. Nothing tastes sweeter than the food you’ve nurtured, grown and picked yourself 💚.

Use frozen and canned fruit and vegetables

They’re still healthy and usually cheaper than produce that’s not in season. They’ll also keep longer. Just make sure you read the ingredients list and nutrition panel. Canned foods may have added salt or sugar. So for vegies, look for ‘no added salt’ on the label, and choose fruits in natural juice with no added sugar rather than canned in syrup.

Shop around and do your research

Just because you’ve always shopped at a particular place doesn’t mean you always have to shop there. Visit the local farmer’s markets, keep an eye on catalogues and join online groups with other savvy shoppers. That way, you’ll always know who’s providing the best value for money for your groceries.

Buy in bulk items you use regularly and have a long shelf life

This includes things like rice, dried/canned legumes and pasta. And the best time to buy them is when they’re on sale. But please don’t go crazy and start hoarding or buying too much 😐. Bulk buying to save money is different to the panic buying we’ve seen during the pandemic. If we all shop for only the things we need, there’ll be plenty for everyone.

Reduce your kitchen waste

Shopping with a list will help, and only buy what you need. Take note of the foods you often throw out because they’ve become a mysterious, furry blob in your fridge. Avoid buying that item, or buy less of it when you shop. Look for ways to use food that’s becoming slightly less than fresh but is still good. Soups are a great way to use the last of the vegies in your fridge crisper. Visit the Foodwise website for tips to help you reduce waste.

Getting takeaway

Let’s face it, there’ll be times when you really, really want takeaway food. It’s quick, easy and delicious 😋. As long as it’s an occasional thing and you eat it in moderation, it shouldn’t have too great an impact on your health or wallet. Here are some tips from Health and Wellbeing Queensland to help you make the healthiest choices when it comes to takeaway food.

Finally, don’t shop when you’re hungry

It’s an easy way to end up with lots of things in your trolley that weren’t on your shopping list. This can blow your budget and plans for healthy eating right out of the water. So shop after you’ve eaten or munch on some fruit or handful of nuts before you even consider walking into the bright lights and air-conditioned aisles of your local shopping centre. Your budget will thank you for it.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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